The prevalence of occupational burnout and its individual and situational predictors among addiction therapists

This study assesses the prevalence and individual and organizational predictors of occupational burnout among addiction therapists. A total of 452 addiction therapists from a representative sample of 184 Polish alcohol treatment facilities (outpatient and inpatient) participated in the study (facility response rate = 42%). The Oldenburg Burnout Inventory was used to measure occupational burnout, and 15 subscales of the Copenhagen Psychosocial Questionnaire II were administered to assess psychosocial work conditions. In addition, the Coronavirus Anxiety Scale, the Hospital Anxiety and Depression Scale and the abbreviated six-item De Jong Gierveld Loneliness Scale measured other important dimensions of addiction therapists' psychosocial functioning. Logistic regression was used for the analysis of the data. Occupational burnout was noticeably prevalent in the study group: 62% of respondents experienced exhaustion and 50% experienced disengagement from work, both to at least a moderate degree. Situational (organizational) variables were the most important predictors, explaining much more of the variance in both dimensions of burnout than the individual factors, of which only depression was significantly related to higher levels of exhaustion. Coronavirus anxiety played a marginal role in explaining the severity of burnout. The current study is one of the first attempts to assess the level of occupational burnout among addiction therapists and to comprehensively investigate the factors contributing to it. The findings provide useful information for the development of interventions aimed at preventing or reducing burnout in this professional group.

Educational and personal burnout and burnout regarding collaborating with fellow university nursing students during COVID-19 in 2020-2021

BACKGROUND

Knowledge is lacking about the effects of COVID-19 on nursing students' burnout symptoms. Burnout can lead to negative feelings and behaviours towards learning and poor mental health.

AIMS

To describe and compare nursing/midwifery students' burnout, explore differences and detect predictors at two time points through COVID-19.

METHODS

Students were offered participation in the spring semesters of 2020 and 2021 (N = 2046), during COVID-19. The response rate was 30-33%. By using reliable and valid instruments, the students' stress and burnout were analysed as well as the students' health and perceived support.

RESULTS

Symptoms of academic burnout were higher among 1st and 2nd year BSc students in 2021. On the contrary, 3rd and 4th year students had higher academic and personal burnout than graduate students as well as than 1st and 2nd year students. Regarding academic burnout, 47% of the variability was explained by educational level, support, stress and the interactional effect of stress and support. Collaborational burnout, predicted by the students' educational level and support, explained 7% of the variability in the outcome. Additionally, educational level, and stress, predicted 52% of the variability in personal burnout.

CONCLUSION

Educators or student counsellors need to facilitate effective learning practices and offer academic support, specifically during 3rd and 4th year to boost helpful coping strategies and handle uncertainty and stressors related to crises such as COVID-19.

The mediating roles of coping styles and academic burnout in the relationship between stressors and depressive symptoms among Chinese postgraduates

Background

Since few studies have incorporated factors like stressors, coping styles, and academic burnout into the same model to analyze their impacts on depressive symptoms, this research attempts to establish an optimal structural model to explore the direct and indirect effects of these factors on depressive symptoms.

Methods

A total of 266 postgraduates completed questionnaires regarding coping styles, academic burnout, stressors, and depressive symptoms. The path analysis was applied for investigating the roles of coping styles and academic burnout in mediating the relationship between stressors and depressive symptoms.

Results

The total and direct effects of stressors on depressive symptoms were 0.53 and 0.31, respectively. The proportion of the direct effect of stressors on depressive symptoms to its total effect amounted to 58.50%. The indirect effects of academic burnout, positive coping style, and negative coping style on the association between stressors and depressive symptoms were 0.11, 0.04, and 0.03, taking up 20.75%, 7.55%, and 5.66% of the total effect, respectively. The serial indirect effect of positive coping style and academic burnout was 0.02, accounting for 3.77% of the total effect, while that of negative coping style and academic burnout was 0.02, taking up 3.77% of the total effect.

Conclusions

Coping styles and academic burnout chain jointly mediate the relationship between stressors and depressive symptoms among postgraduates. Thus, encouraging postgraduates to tackle stress positively may reduce the likelihood of the development of academic burnout and further reduce depressive symptoms.

Parental burnout features and the family context: A temporal network approach in mothers

Many parents have days where they encounter emotional exhaustion, emotional distance from their children, and feeling fed up with being a parent. Some parents experience these characteristics to a severe extent-a clinical phenomenon termed parental burnout. Parental burnout arises when parents chronically endure severe stress without sufficient resources to cope, which may lead to detrimental consequences not only for the parent but also for their partner (e.g., marital conflict) and children (i.e., neglect and violence). However, uncertainty remains regarding how these features interact and trigger one another over time (potentially becoming increasingly severe), nor how the daily variations of the family context influence these features. Therefore, in this study, we recruited 50 parents (with main analyses focusing on 43 mothers with a co-parent, and sensitivity analyses with the full sample) from the general population to rate the core features of parental burnout and the family context daily over 56 days. We used multilevel vector autoregressive models to generate network models. Results suggest that exhaustion contributes to parental burnout: It self-predicts and is closely associated with feeling fed up and finding children difficult to manage. Distance, by contrast, is mainly negatively connected to sharing positive moments with children. Contextual variables also interact with parental burnout features, illustrating the relevance of examining parenting within the family system context. If future research confirms a central role of exhaustion in parental burnout development, prevention efforts can focus on decreasing parental exhaustion. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Students' Burnout at University: The Role of Gender and Worker Status

Students' burnout has been widely investigated in recent decades, mainly showing a higher risk for female students across academic levels. To our knowledge, few studies have investigated whether employed students experience higher academic burnout risks. In this regard, previous findings have shown mixed results. The current study investigated the differences in burnout experience based on students' gender and worker status. We expected to find differences among study groups in their burnout levels. The participants were 494 Italian university students (49.6% female students; 49.4% working students) who completed the short version of the Burnout Assessment Tool Core dimensions (BAT-C). Firstly, we investigated the BAT-C measurement invariance across gender and worker status subgroups. Secondly, a multivariate analysis of variance (MANOVA) showed significant gender differences in burnout levels. Specifically, female students showed higher levels of exhaustion, cognitive impairment, and emotional impairment than male students. Nevertheless, no interactive effects between gender and worker status were observed in the current sample. To sum up, gender is a key factor for understanding several BAT symptoms, and it should be considered by academic staff interested in preventing burnout at university and its dropout consequences.

The impact of social support and stress on academic burnout among medical students in online learning: The mediating role of resilience

Background

As the COVID-19 pandemic continues, online learning and long-term isolation from social and clinical settings has exacerbated mental health problems and symptoms of academic burnout among medical students. However, few studies have discussed symptoms of academic burnout as a result of reduced social support, and increased stress among medical students during the process of online learning. To fill this gap, this study investigated the influencing factors and mechanism of academic burnout in medical students' online learning process. Both the positive inhibition effect of positive factors such as social support, and the negative aggravation effect of negative factors such as stress were explored, while the mediating and protecting role of resilience is also discussed.

Method

We collected survey data from a total of 817 medical students from a medical school in China who participated in online learning during the fall 2021 semester. An online questionnaire was sent to the students in January, 2022. Items adapted from the DASS Scale developed by Lovibond and Lovibond were used to measure medical students' stress levels. The perceived social support of medical students was assessed by the Gregory MSPSS. Resilience was evaluated by the 10-Item Connor–Davidson Resilience Scale (CD-RISC). Items from the Maslach Burnout Inventory–Student Survey (MBI-SS) were used to calculate students' academic burnout. Descriptive analysis, correlation analysis, hierarchical linear regression analysis and structural equation modeling were used to analyze the collected data.

Results

The results identified that in the context of online learning there was a positive correlation between medical students' stress and academic burnout, and their resilience played a partial mediating role. However, social support did not directly affect academic burnout, but inhibited the prevalence of academic burnout through resilience. In addition, stress was negatively related to resilience, while social support was positively related to resilience. Resilience was found to be negatively related to medical students' academic burnout in online learning.

Conclusion

The results of this study can provide a reference for the future development of appropriate educational strategies and coping measures to ameliorate the academic burnout of medical students.

Burnout in International Medical Students: Characterization of Professionalism and Loneliness as Predictive Factors of Burnout

BACKGROUND

Burnout is a common mental problem in medical students. For those who are following medical studies abroad there is a higher risk of suffering this syndrome, due to the combination of academic stress and the stress derived from their new living situation. This study was performed with the purpose of testing the following hypothesis: in medical students enrolled in medical programs abroad, abilities associated with professionalism and family support play a protective role in the prevention of suffering burnout.

METHODS

A cross-sectional study was performed in the Faculty of Medicine of the University of Zagreb, where a fully English medical program is offered. The general version of the Maslach Burnout Inventory (MBI-GS) was used as a dependent variable, while Jefferson Scales of empathy, teamwork, and physician lifelong learning and the Social and Emotional Loneliness Scale for Adults were used as predictive variables. In addition, information related to sex, country of birth, native language, age, academic achievement, and living situation were collected in a socio-demographic form. Linear regression models were applied to identify predictors of burnout.

RESULTS

In a sample composed of 188 medical students (38 Croatians and 144 foreigners from 28 countries), 18% of the global score in the MBI-GS was explained by lifelong learning and family loneliness. A separate analysis for each domain of the MBI-GS allowed the creation of three models: the first model explained 19% of the variance of the "exhaustion" domain by "country of birth", "living with parents", "academic year", and "cynicism"; a second model explained 24% of the variance of the "cynicism" domain by "academic year", "empathy", "lifelong learning", and "exhaustion"; and finally, a third model explained 24% of the variance of the "professional efficacy" domain by "lifelong learning", "family loneliness", and "cynicism". All obtained models presented an effect size between medium and large, as well as matching the required conditions for statistical inference.

CONCLUSIONS

These findings confirm the important role that family plays as a source of support for medical students. Empathy and lifelong learning, two specific elements of medical professionalism, appear as protective factors in the prevention of burnout in international students.

Reliability and validity study of the Thai adaptation of the Copenhagen Burnout Inventory-Student Survey (CBI-SS) among preclinical medical students at the Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand

Burnout syndrome is a syndrome of emotional exhaustion, professional efficacy and cynicism. A significant proportion of medical students reported having burnout syndrome during their training in medical education. Several tools including the Copenhagen Burnout Inventory-Student Survey (CBI-SS) are considered to be a valid measurement of burnout syndrome in medical students. This study aimed to translate, culturally adapt, and validate the CBI-SS for assessing burnout syndrome among preclinical medical students in Thailand. This study was conducted during February to March 2019 at the Faculty of Medicine Siriraj Hospital, Mahidol University (Bangkok, Thailand), which is Thailand’s largest and oldest medical school, and Thailand’s largest national tertiary referral center. After receiving formal permission to do so from the copyright owner, the original English language version of the CBI-SS was translated to Thai language using an internationally recommended and accepted forward-backward translation protocol. The Thai version of the CBI-SS (Thai CBI-SS) comprises 25 items, including 6 items for personal burnout, 7 items for study-related burnout, 6 items for colleague-related burnout, and 6 items for teacher-related burnout. Standardized Cronbach’s alpha coefficient was calculated to evaluate internal consistency reliability, and correlation coefficient was computed to determine test-retest reliability. A total of 414 preclinical medical students participated in this study. Due to sub-optimal factor weights (<0.50), items 6, 10 and 17 were excluded. The Cronbach’s alpha coefficients of the 22-item Thai CBI-SS for personal, study-related, colleague-related, and teacher-related burnout were 0.898, 0.896, 0.910 and 0.900 respectively. The correlation coefficients for test-retest reliability after three weeks were 0.820, 0.870, 0.821, and 0.787 for personal, study-related, colleague-related, and teacher-related burnout, respectively. Maximum likelihood analysis with oblimin rotation indicated four main components, and confirmatory factor analysis revealed good fit indices of the Thai CBI-SS. Confirmatory factor analysis showed good fit indices of CBI-SS domains (χ2/df = 2.39; CFI = 0.957; GFI = 0.909; RMSEA = 0.058; TLI = 0.949; and NFI = 0.928). The convergent validity analysis using the Average Variance Extracted (AVE) and the Composite Reliability (CR) was adequate for all dimensions (personal: AVE = 0.626, CR = 0.893; study-related: AVE = 0.601, CR = 0.899; colleague-related: AVE = 0.677, CR = 0.913; teacher-related: AVE = 0.606, CR = 0.900). The HTMT values for all variables are in the range from 0.315 to 0.833, confirming the discriminant validity. The Thai CBI-SS was found to be a valid and reliable tool for evaluating burnout syndrome in preclinical medical students in Thailand.

Chinese mothers' parental burnout and adolescents' internalizing and externalizing problems: The mediating role of maternal hostility

Parental burnout is a state that parents feel exhausted in their parental role. Although past research has examined concurrent correlates of parental burnout, the impacts of parental burnout on adolescent development over time remain largely unknown. The current study explored the indirect mechanisms linking mothers' parental burnout to adolescents' later internalizing and externalizing problems through maternal hostility among Chinese families. Using a sample of 606 adolescents (51.5% boys; M_age = 12.89 years old) and their mothers (M_age = 38.50 years old), this three-wave longitudinal study showed that mothers' parental burnout was predictive of adolescents' perceptions of their mothers' parental hostility over time, which were in turn related to adolescents' later internalizing and externalizing problems. Moreover, mothers' parental burnout was directly related to adolescents' later externalizing problems. Taken together, parental burnout played a role in adolescents' internalizing and externalizing problems over time through increased parental hostility. These findings underscore the importance of parental burnout on parenting behavior and adolescent adjustment. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Association of Characteristics of the Learning Environment and US Medical Student Burnout, Empathy, and Career Regret

IMPORTANCE

Previous studies have shown that medical student mistreatment and burnout are common. However, few longitudinal data exist to describe how mistreatment and other learning environment experiences are associated with subsequent burnout and other student characteristics.

OBJECTIVE

To examine the association between mistreatment and perceptions of the learning environment with subsequent burnout, empathy, and career regret among US medical students.

DESIGN, SETTING, AND PARTICIPANTS

This cohort study analyzed data from the 2014-2016 Association of American Medical Colleges (AAMC) Medical School Year 2 Questionnaire (Y2Q) and 2016-2018 AAMC Graduation Questionnaire (GQ). Medical students from 140 allopathic medical schools who responded to both AAMC surveys were included in the analysis. Data were analyzed from December 1, 2019, to January 11, 2021.

EXPOSURES

Self-reported medical student mistreatment (eg, experiences of negative behaviors and discrimination related to sex, race/ethnicity, and sexual orientation) and perceptions of the learning environment (Medical School Learning Environment Survey subscales for faculty, emotional climate, and student-student interactions).

MAIN OUTCOMES AND MEASURES

Burnout, empathy, and career regret as measured by Oldenburg Burnout Inventory data for burnout, Interpersonal Reactivity Index scores for empathy, and a single item assessing career regret.

RESULTS

Data from 14 126 medical students were analyzed; 52.0% were women, and the mean (SD) age was 27.7 (2.9) years at graduation. Mistreatment was reported by 22.9% of respondents on the Y2Q. In multivariable analysis adjusted for Y2Q measures, mistreatment reported on the Y2Q was associated with a higher exhaustion score (1.81 [95% CI, 1.60-2.02]), a higher disengagement score (0.71 [95% CI, 0.58-0.84]), and higher likelihood of career regret on the GQ (186 of 989 [18.8%]; all P < .001). A more positive emotional climate reported on the Y2Q was associated with a lower exhaustion score (for each 1-point increase, -0.05 [95% CI, -0.08 to -0.02]; P = .001) and lower disengagement score (for each 1-point increase, -0.04 [95% CI, -0.06 to -0.02]; P < .001) on the GQ. More positive faculty interactions on the Y2Q were associated with higher empathy score on the GQ (for each 1-point increase, 0.02 [95% CI, 0.01-0.05]; P = .04). Better student-student interactions were associated with lower odds of career regret during year 4 of medical school (odds ratio for each 1-point increase, 0.97 [95% CI, 0.95-1.00]; P = .04).

CONCLUSIONS AND RELEVANCE

The findings of this cohort study suggest that medical students who experienced mistreatment and perceived the learning environment less favorably were more likely to develop higher levels of exhaustion and disengagement, lower levels of empathy, and career regret compared with medical students with more positive experiences. Strategies to improve student well-being, empathy, and experience should include approaches to eliminate mistreatment and improve the learning environment.

Emotional intelligence as a mediator in the relationship between academic performance and burnout in high school students

Low performance of high school students and repeating a year are major problems in the education system. Low performance in the classroom generates negative emotions in young people and has been related to development of school burnout. The objective of this study was to analyze the repercussions of academic performance on burnout in high school students, and establish the role of emotional intelligence in this relationship. The sample was made up of 1287 high school students aged 14 to 18, who filled out questionnaires for evaluation of these variables. The results showed that youths who had failed a subject or had repeated a year showed more exhaustion and cynicism than their classmates with better performance and higher academic efficacy. A relationship was also found between school burnout and emotional intelligence in these adolescents, positive for self-efficacy and negative for cynicism and exhaustion. The model results showed that low academic performance affected burnout level, and that stress management and mood in emotional intelligence acted as a mediator in this relationship. In conclusion, development of emotional intelligence programs in the educational context is proposed as a measure for preventing burnout in the face of adverse high school academic events, such as failing or repeating a year.

Interests, Motives, and Psychological Burdens in Times of Crisis and Lockdown: Google Trends Analysis to Inform Policy Makers

BACKGROUND

In the face of the COVID-19 pandemic, the German government and the 16 German federal states implemented a variety of nonpharmaceutical interventions (NPIs) to decelerate the spread of the SARS-CoV-2 virus and thus prevent a collapse of the health care system. These measures comprised, among others, social distancing, the temporary closure of shops and schools, and a ban of large public gatherings and meetings with people not living in the same household.

OBJECTIVE

It is fair to assume that the issued NPIs have heavily affected social life and psychological functioning. We therefore aimed to examine possible effects of this lockdown in conjunction with daily new infections and the state of the national economy on people's interests, motives, and other psychological states.

METHODS

We derived 249 keywords from the Google Trends database, tapping into 27 empirically and rationally selected psychological domains. To overcome issues with reliability and specificity of individual indicator variables, broad factors were derived by means of time series factor analysis. All domains were subjected to a change point analysis and time series regression analysis with infection rates, NPIs, and the state of the economy as predictors. All keywords and analyses were preregistered prior to analysis.

RESULTS

With the pandemic arriving in Germany, significant increases in people's search interests were observed in virtually all domains. Although most of the changes were short-lasting, each had a distinguishable onset during the lockdown period. Regression analysis of the Google Trends data confirmed pronounced autoregressive effects for the investigated variables, while forecasting by means of the tested predictors (ie, daily new infections, NPIs, and the state of economy) was moderate at best.

CONCLUSIONS

Our findings indicate that people's interests, motives, and psychological states are heavily affected in times of crisis and lockdown. Specifically, disease- and virus-related domains (eg, pandemic disease, symptoms) peaked early, whereas personal health strategies (eg, masks, homeschooling) peaked later during the lockdown. Domains addressing social life and psychosocial functioning showed long-term increases in public interest. Renovation was the only domain to show a decrease in search interest with the onset of the lockdown. As changes in search behavior are consistent over multiple domains, a Google Trends analysis may provide information for policy makers on how to adapt and develop intervention, information, and prevention strategies, especially when NPIs are in effect.

Health-Promoting Leadership During an Infectious Disease Outbreak: A Cross-Sectional Study of US Soldiers Deployed to Liberia

ABSTRACT

Infectious disease outbreaks are uniquely stressful for essential employees. One way to support workers is for supervisors to engage in behaviors promoting employees' well-being and attitudes toward preventive medicine practices. We examined whether health-promoting leadership contributes to these outcomes in a population of active-duty soldiers (N = 173) deployed to provide nonmedical support in Liberia during the 2014 Ebola epidemic using data reported in Sipos, Kim, Thomas, and Adler (Mil Med 183[3-4]:e171-e178, 2018). Soldiers completed surveys assessing posttraumatic stress disorder (PTSD), depression, anxiety, sleep problems, burnout, morale, and attitudes and rated their leaders on health-promoting behaviors. Using mixed-effects logistic regression, health-promoting leadership focused on psychological health was associated with decreased odds of PTSD, depression, anxiety, and burnout, and increased odds of high morale and avoiding unnecessary risk. Health-promoting leadership focused on preventive medicine was associated with decreased odds of depression and anxiety, and increased odds of high morale, positive attitudes, and avoiding unnecessary risk. Findings suggest health-promoting leadership could be valuable for workers responding to epidemics.

Determinants of burnout and other aspects of psychological well-being in healthcare workers during the Covid-19 pandemic: A multinational cross-sectional study

The Covid-19 pandemic has placed unprecedented pressure on healthcare systems and workers around the world. Such pressures may impact on working conditions, psychological wellbeing and perception of safety. In spite of this, no study has assessed the relationship between safety attitudes and psychological outcomes. Moreover, only limited studies have examined the relationship between personal characteristics and psychological outcomes during Covid-19. From 22nd March 2020 to 18th June 2020, healthcare workers from the United Kingdom, Poland, and Singapore were invited to participate using a self-administered questionnaire comprising the Safety Attitudes Questionnaire (SAQ), Oldenburg Burnout Inventory (OLBI) and Hospital Anxiety and Depression Scale (HADS) to evaluate safety culture, burnout and anxiety/depression. Multivariate logistic regression was used to determine predictors of burnout, anxiety and depression. Of 3,537 healthcare workers who participated in the study, 2,364 (67%) screened positive for burnout, 701 (20%) for anxiety, and 389 (11%) for depression. Significant predictors of burnout included patient-facing roles: doctor (OR 2.10; 95% CI 1.49-2.95), nurse (OR 1.38; 95% CI 1.04-1.84), and 'other clinical' (OR 2.02; 95% CI 1.45-2.82); being redeployed (OR 1.27; 95% CI 1.02-1.58), bottom quartile SAQ score (OR 2.43; 95% CI 1.98-2.99), anxiety (OR 4.87; 95% CI 3.92-6.06) and depression (OR 4.06; 95% CI 3.04-5.42). Significant factors inversely correlated with burnout included being tested for SARS-CoV-2 (OR 0.64; 95% CI 0.51-0.82) and top quartile SAQ score (OR 0.30; 95% CI 0.22-0.40). Significant factors associated with anxiety and depression, included burnout, gender, safety attitudes and job role. Our findings demonstrate a significant burden of burnout, anxiety, and depression amongst healthcare workers. A strong association was seen between SARS-CoV-2 testing, safety attitudes, gender, job role, redeployment and psychological state. These findings highlight the importance of targeted support services for at risk groups and proactive SARS-CoV-2 testing of healthcare workers.

A Bio-Physio-Psychological Investigation of Athletes' Burnout

Purpose: Changes in biophysiological markers related to perceived burnout and self-comfort were tested in this study. Method: Forty-two student-athletes from middle and high school grades were evaluated for burnout, salivary cortisol levels, measures of arousal-related physiological markers (i.e., blood volume pulse; BVP), galvanic skin response (GSR), and respiratory rate, and self-comfort variables during the last two weeks of the season. Using self-comfort theory as its conceptual framework, we examined burnout through a conceptual model in which feeling of discomfort with the self was related to biophysiological markers affecting perceived burnout. The proposed model was tested by using a partial least squares structural equation modeling (PLS-SEM). Results: The main findings indicate that increased self-discomfort is significantly (p < .001) associated with increased salivary cortisol (β = - 0.189) along with a significant (p = .050) decrease in GSR (β = - 0.259). Increased salivary cortisol is significantly (p < .001) associated with increased burnout (β = 0.242). Conclusion: The findings partially support the model and encourage further effort to capture the burnout syndrome through the integration of biological and psychological markers.

[Burn-out: an elusive concept]

Approximately 1 in 6 citizens report burn-out symptoms. But what does this mean? Many people sooner or later suffer from fatigue, irritability, and sleeping problems. When do these symptoms become so severe that they become a burn-out? Discussions about the causes and solutions for burn-out are common, but it is important not to lose sight that burn-out has a limited scientific basis. There are changing definitions over time, no reliable diagnostic interview, a large overlap between burn-out and depression, and no evidence-based treatments. Thus, burn-out remains an elusive concept. The impact and suffering of what we call burn-out is undeniably real and poses a great problem, but can we really help people in their recovery if our knowledge of burn-out is so limited? In this perspective, I pose critical questions about the current scientific state of burnout, but also want to argue that there is a constructive way forward based on recently acquired knowledge about stress and its inherent dynamics that perhaps offers a fundamentally different approach to understand burn-out.

Quality and Safety in Healthcare, Part LXVI: Contributing Causes of Poor Well-being in Medical Students

ABSTRACT

Problems in the learning environment are the main contributing factors to medical student burnout. These issues include stresses from mistreatment, poor support, cynical supervisors, pressure to get good grades and learn a huge amount of information quickly, fatigue, lack of control, and so on. Personal risk factors include having been seriously ill recently, having a low grit score, being in debt, and having a job.

A network approach to parental burnout

BACKGROUND

The use of network analyses in psychology has increasingly gained traction in the last few years. A network perspective views psychological constructs as dynamic systems of interacting elements.

OBJECTIVE

We present the first study to apply network analyses to examine how the hallmark features of parental burnout - i.e., exhaustion related to the parental role, emotional distancing from children, and a sense of ineffectiveness in the parental role - interact with one another and with maladaptive behaviors related to the partner and the child(ren), when these variables are conceptualized as a network system.

PARTICIPANTS AND SETTING

In a preregistered fashion, we reanalyzed the data from a French-speaking sample (n = 1551; previously published in Mikolajczak, Brianda et al., 2018), focusing on seven specific variables: the three hallmark parental burnout features, partner conflict, partner estrangement, neglectful behavior toward children, and violent behavior toward children.

METHODS

We computed two types of network models, a graphical Gaussian model to examine network structure, potential communities, and influential nodes, and a directed acyclic graph to examine the probabilistic dependencies among the different variables.

RESULTS

Both network models pointed to emotional distance as an especially potent mechanism in activating all other nodes.

CONCLUSIONS

These results suggest emotional distance as critical to the maintenance of the parental burnout network and a prime candidate for future interventions, while affirming that network analysis can successfully expose the structure and relationship of variables related to parental burnout and its consequences related to the partner and the child(ren).

A network approach to parental burnout

BACKGROUND

The use of network analyses in psychology has increasingly gained traction in the last few years. A network perspective views psychological constructs as dynamic systems of interacting elements.

OBJECTIVE

We present the first study to apply network analyses to examine how the hallmark features of parental burnout - i.e., exhaustion related to the parental role, emotional distancing from children, and a sense of ineffectiveness in the parental role - interact with one another and with maladaptive behaviors related to the partner and the child(ren), when these variables are conceptualized as a network system.

PARTICIPANTS AND SETTING

In a preregistered fashion, we reanalyzed the data from a French-speaking sample (n = 1551; previously published in Mikolajczak, Brianda et al., 2018), focusing on seven specific variables: the three hallmark parental burnout features, partner conflict, partner estrangement, neglectful behavior toward children, and violent behavior toward children.

METHODS

We computed two types of network models, a graphical Gaussian model to examine network structure, potential communities, and influential nodes, and a directed acyclic graph to examine the probabilistic dependencies among the different variables.

RESULTS

Both network models pointed to emotional distance as an especially potent mechanism in activating all other nodes.

CONCLUSIONS

These results suggest emotional distance as critical to the maintenance of the parental burnout network and a prime candidate for future interventions, while affirming that network analysis can successfully expose the structure and relationship of variables related to parental burnout and its consequences related to the partner and the child(ren).

Correlation between academic self-efficacy and burnout originating from distance learning among nursing students in Indonesia during the coronavirus disease 2019 pandemic

PURPOSE

Distance learning, which became widespread in response to the coronavirus disease 2019 (COVID-19) pandemic, has been a burdensome challenge for students and lecturers. This study investigated the relationship between academic self-efficacy and burnout in first-year nursing students who participated in distance learning during the COVID-19 pandemic.

METHODS

The study included 69 first-year nursing students at Jenderal Achmad Yani University in Yogyakarta, Indonesia. Data were collected in September 2020 through self-efficacy and burnout questionnaires that were distributed via email and social media for 2 weeks. The responses were analyzed using the gamma test.

RESULTS

Most respondents were women (78.3%), with an average age of 19 years. Most nursing students had a moderate level of academic self-efficacy (72.5%), while only 13.0% of respondents had a low level of academic self-efficacy. However, 46.4% of students experienced severe burnout during distance learning. Cross-tabulation showed that students with moderate self-efficacy were more likely to experience severe burnout (24 respondents) (P<0.01 and r=-0.884). Exhaustion was the burnout dimension most closely associated with academic self-efficacy.

CONCLUSION

Students perceived distance learning as burdensome and reported high levels of exhaustion, which may negatively impact their academic achievement. Interventions to improve academic self-efficacy may foster students’ confidence, potentially leading to reduced burnout levels. Nurse educators should reflect upon innovative learning strategies to create a favorable learning environment for nursing students.

Stress, burnout and diminished safety behaviors: An argument for Total Worker Health® approaches in the fire service

INTRODUCTION

Firefighting is stressful work, which can result in burnout. Burnout is a safety concern as it can negatively impact safety outcomes. These impacts are not fully understood within the fire service. Further, the fire service needs support that safety strategies are needed to protect and promote the health and wellbeing of firefighters.

METHODS

Structural equation modeling was completed to examine a hypothesized model that linked stress and burnout to diminished safety behavior outcomes among a sample of career firefighters.

RESULTS

Findings support a full mediation model. Firefighter stress perceptions were positively associated with burnout and burnout was negatively associated with safety compliance behavior, personal protective equipment behavior, safe work practices, and safety citizenship behavior.

CONCLUSIONS

These results illustrate the negative impact of health impairment on firefighter safety behaviors. Practical Applications: These outcomes suggest that interventions aimed at protecting and promotion firefighter health are needed. Total Worker Health® (TWH) approaches may provide the framework for these interventions.

Parenting-Related Exhaustion During the Italian COVID-19 Lockdown

OBJECTIVE

Worldwide, the coronavirus disease 2019 (COVID-19) pandemic has generated significant worry, uncertainty, anxiety, sadness, and loneliness. In Italy, these effects have been particularly pronounced. While research on the COVID-19 outbreak has mainly focused on the clinical features of infected patients and the psychological impact on the general population and health professionals, no investigation has yet assessed the psychological impact of the pandemic on parents. In the present research, we conducted a web-based survey of Italian parents to examine the prevalence of parenting-related exhaustion-and to identify its associated risk and protective factors-4 weeks into the lockdown.

METHODS

A total of 1,226 parents provided their consent to participate in the study and completed a demographic questionnaire, information relating to particular COVID-19 experiences, and measures of emotional exhaustion, parental resilience, social connections, and psychological distress during the lockdown.

RESULTS

Seventeen percent of our sample experienced significant parenting-related exhaustion, with mothers more severely affected. Multiple regression analyses showed that greater parenting-related exhaustion was predicted by psychological distress, lower parental resilience, motherhood, fewer perceived social connections, and being single, as well as having a child with special needs, having a large number of children, and having younger children.

CONCLUSION

The findings add further support to the call for preventive programs to support parents throughout the COVID-19 pandemic. Mental health professionals and social workers should be warned of the effects of lockdown and social distancing on parenting and, consequently, the well-being of children.

New insights into diabetes burnout and its distinction from diabetes distress and depressive symptoms: A qualitative study

AIMS

This study aimed to corroborate the main hypotetized dimensions of diabetes burnout, and its distinction from diabetes distress and depressive symptoms among adults with type 1 diabetes (T1D).

METHODS

A qualitative descriptive study was employed to collect data from 31 eligible participants using semi-structured individual phone interviews. Participants were recruited through purposive sampling among a larger sample of adults with T1D in a previous study. Data was analyzed using qualitative content analysis including immersion, reduction, and interpretation.

RESULTS

Exhaustion and detachment were frequent manifestations of diabetes burnout that often accompanied by instances during which participants experienced a loss of control over diabetes. Whereas individuals' support systems could either help or hinder diabetes burnout. Participants saw burnout as separate but closely related to distress and depressive symptoms, with some suggesting correlations among burnout, distress, and depressive symptoms, while others expressed that distress caused their burnout and depressive symptoms.

CONCLUSIONS

Diabetes burnout reflects a significant yet unexplored concept which might explain the complexities of suboptimal self-management and poor diabetes outcomes. Emerging evidence suggesting diabetes burnout as a distinct concept calls for more studies to mitigate diabetes burnout as an obstacle to optimal diabetes care.

Testing Boundaries COVID-19 made the USMLE, Clerkships a Moving Target for Med Students

Medical schools typically have predictable schedules. The timing of lectures, clerkships, exams, and even extracurricular activities tend to follow in the same grooves year after year. Students can reliably block out even minor events months ahead of time and be confident they'll take place. All that changed with COVID-19. Since March, when the pandemic began closing down schools, businesses, and other institutions across the state, figuring out what comes next in medical school has been anything but predictable.

Descriptions of diabetes burnout from individuals with Type 1 diabetes: an analysis of YouTube videos

AIM

The purpose of the study was to analyse self-descriptions of diabetes burnout in individuals with Type 1 diabetes via YouTube videos.

METHODS

In this qualitative descriptive study, a systematic approach was used to search YouTube videos with a title, description or content specifically about diabetes burnout dated between 2007 and 2017. Irrelevant or duplicated videos were excluded using eligibility criteria. All videos meeting inclusion criteria (n = 32) from individuals with Type 1 diabetes were transcribed verbatim and analysed using a qualitative content analysis approach. Descriptive statistics were used to analyse video characteristics.

RESULTS

The four major themes associated with diabetes burnout were: (i) feeling mentally drained and physically tired of dealing with self-care; (ii) experiencing a detachment from self, diabetes care and support system; (iii) being powerless and paralysed to 'climb out' of diabetes burnout; and (iv) contributing potential factors to diabetes burnout.

CONCLUSIONS

Self-descriptions of diabetes burnout suggest that it is a combination of emotions and behaviours on a spectrum from exhaustion to detachment accompanied by an overwhelming sense of powerlessness. More studies are needed to further clarify diabetes burnout and its distinction from, or overlap with, other related psychosocial concepts in diabetes care.

Effect of digital storytelling intervention on burnout thoughts of adolescent: Athletes with disabilities

BACKGROUND/OBJECTIVE

Both athletes with and without disabilities can develop burnout symptoms. However, athletes with disabilities may face different or more challenges compared to their counterparts without disabilities. The present study aimed at ascertaining the effect of digital storytelling intervention on burnout thoughts of adolescent-athletes with disabilities.

METHOD

This study is a randomized controlled trial involving a total of 171 adolescent-athletes with disabilities who showed a high degree of burnout symptoms. These adolescent-athletes were randomly assigned to either an intervention group (n = 85) or a waitlisted control group (n = 86). The treatment intervention for the adolescent-athletes was digital stories which were created based on the framework of rational emotive behaviour therapy (REBT). The Athlete Burnout Questionnaire was used for gathering of data at three different times (baseline, post-test and follow up). Data were analyzed using repeated measure analysis of variance at a significant level of 0.05.

RESULTS

Results showed that the digital storytelling intervention based on REBT significantly reduced burnout thoughts among disabled adolescent-athletes in the intervention group compared to athletes in the waitlisted control group as measured by the Athlete Burnout Questionnaire. Additionally, at follow-up evaluation, it was observed that the decrease in burnout scores was maintained by those athletes in the digital storytelling intervention.

CONCLUSION

Digital storytelling intervention based on rational emotive behaviour therapy shows great potentials in addressing burnout among adolescent-athletes with disabilities.

Burnout Syndrome and Work-Related Stress in Physical and Occupational Therapists Working in Different Types of Hospitals: Which Group Is the Most Vulnerable?

Because of the nature of their work, physical and occupational therapists are at high risk of burnout, which is associated with decreased job satisfaction, medical errors, and mental wellbeing in healthcare professionals. To well manage and minimize potential impact of burnout, risk factors should be determined. This study examined burnout and job stress in physical and occupational therapists in various Korean hospital settings. Physical and occupational therapists from several rehabilitation facilities in South Korea completed a survey between March-May 2019. A set of questionnaires, including the Maslach Burnout Inventory and Job Content Questionnaire, were distributed to all participants. In total, 325 professionals (131 men and 194 women) were recruited. Burnout and work-related stress differed significantly according to several factors. Hospital size, gender, and age were the main contributory factors affecting at least two dimensions of the questionnaires. The more vulnerable group consisted of female therapists in their 20s at small- or medium-sized hospitals with low scores for quality of life. High levels of job stress and burnout were observed in female therapists in their 20s at small- or medium-sized hospitals. Hospitals and society should create suitable environments and understand the nature of therapists' work to improve healthcare.

Burnout: Re-examining its key constructs

There is widespread debate as to how to accurately define and measure burnout. The present study sought to address these issues by inviting participants who self-identified as experiencing burnout to complete a questionnaire covering a large item set of putative burnout features. Bifactor modelling identified a 'general' factor with items capturing exhaustion as well as psychological and cognitive dysfunction. Three additional 'specific' factors were also generated that delineated work-focused, inability to feel and compromised work functioning constructs. Similar factors were found when those still working and those no longer working were compared. Results indicate a new heuristic diathesis-stress model of burnout.

[Psychiatry in the time of pandemic : forging new ways without getting lost]

Coronavirus pandemic challenges mental health care providers in different ways. At an individual level, they have to adapt their clinical practice and consider specific issues of teleconsultations to address patient's needs. At a population level, dedicated interventions (e.g. hotlines, health professionals' support) have to strike a balance between « pathologizing » people's reactions and trivializing the psychological effects of a pandemic. Finally, psychiatric leaders must be able to advise decision-makers on mental-health policy and communication.

Could recruiting former college athletes be the answer to less pharmacy student burnout?

INTRODUCTION

Student pharmacists are in a notable wellness deficit. Pharmacy organizations are issuing statements and providing resources addressing efforts to increase student wellness. This commentary suggests that institutions refocus recruiting efforts on students with experience balancing the demands of school, wellness, and mental health.

PERSPECTIVE

The purpose of this commentary is to start the conversation on increasing efforts to recruit candidates who already possess the resilience needed to perform in pharmacy school, with a focus on former college athletes. This piece in no way suggests decreased attention on wellness programs or efforts to reduce burnout. Former student athletes, through their training, have increased experience in resilience and may be less at risk for burnout. These candidates will likely have an increased team mentality and acceptance of constructive criticism. Additionally, this is an untapped resource for candidates as only 2% of collegiate athletes pursuing professional athletic careers. Of the 140 accredited pharmacy schools, 82.9% have an undergraduate program that offers at least one National Collegiate Athletic Association sport.

IMPLICATIONS

Schools of pharmacy should consider additional recruitment efforts and admissions criteria weight for former student athletes who meet the same standards as other candidates. As many pharmacy faculty direct significant effort toward the prevention of student burnout, perhaps an additional approach is to recruit students who are already capable of the expected demands. The athletic community may answer both the need for additional pharmacy recruits and provide a cohort with advanced abilities in stress management, wellness, and teamwork.

The mediating effect of resilience on the relationship between the academic burnout and psychological well-being of medical students

PURPOSE

This study aimed to examine the medicating effect of resilience on the relationship between academic burnout and psychological well-being of medical students.

METHODS

The participants were a group of 97 medical students. Scales measuring Maslach Burnout Inventory-Student Survey, Ryff's Psychological Well-Being, and Korean Resilience Quotient-53 were utilized. The data were analyzed by descriptive statistics, correlation analysis, t-test, and multiple regression analyses using IBM SPSS ver. 22.0 (IBM Corp., Armonk, USA).

RESULTS

According to the study results, the medical students' psychological well-being was negatively correlated with their academic burnout and positively correlated with their resilience; the degree of academic burnout experienced by the first and second year preclinical students was greater than that experienced by the third and fourth year clinical students; the male students' average score for cynicism was higher than that of the female students; and the significant effects of academic burnout on the medical students' psychological well-being were mediated by resilience.

CONCLUSION

It was confirmed that medical students' academic burnout and resilience are significant factors that explain their psychological well-being; resilience is also an important variable in improving psychological well-being. This suggests that education and counseling support are needed to increase medical students' resilience in order to increase their psychological well-being.

Burnout and imposter syndrome among Saudi young adults. The strings in the puppet show of psychological morbidity

OBJECTIVES

To determine the prevalence of imposter syndrome (IS) among Saudi adults and its association with burnout.

METHODS

Using non-probability convenience sampling, we carried out a cross-sectional analytical study among adults in Northern Saudi Arabia. Data collection toll was a self-administered questionnaire containing young imposter scale (YIS), Maslach burnout inventory (MBI) and depression, anxiety, and stress scale 21 (DASS 21). These 3 scales are valid and reliable measurement tools for measuring IS, burnout, and psychological morbidity.

RESULTS

In the study sample (n=384), imposterism was present among 222 adults (57.8%). Moderate and severe symptoms of depression were present in 217 (56.5%), symptoms of stress in 210 (54.7%), and symptoms of anxiety in 126 (32.8%). Burnout was measured in 3 domains of depersonalization, emotion exhaustion, and personal accomplishments. High degree of depersonalization was found in 221 (57.6%), higher emotional exhaustion in 246 (64.1%) while lower personal accomplishment was present in 126 (32.8%). We found statistical association between IS and gender (p less than 0.01), depression (p less than 0.001) stress (p less than 0.001) and all 3 domains of burnout (p less than 0.01). Imposter syndrome was not found associated with anxiety (p=0.97). Young imposter scale score was associated with all the 3 domains of burnout even after controlling for depression, anxiety, and stress.

CONCLUSION

Imposter syndrome is frequent among Saudi adults and associated with all 3 burnout domains. Mental health domains like burnout, depression, stress, and anxiety were found associated with IS.

Investigation of burnout syndrome and job-related risk factors in veterinary technicians in specialty teaching hospitals: a multicenter cross-sectional study

OBJECTIVES

To investigate veterinary technician burnout and associations with frequency of self-reported medical error, resilience, and depression and job-related risk factors.

DESIGN

Cross-sectional observational study using an anonymous survey conducted between November 2017 and June 2018.

SETTING

Four referral teaching hospitals in the United States and Canada.

SUBJECTS

A total of 344 veterinary technicians were invited to participate. Response rate was 95%. Overall 256 surveys were ultimately analyzed.

INTERVENTIONS

Burnout, depression, and resilience were measured using validated instruments. Respondents reported perceptions of workload, working environment, and medical error frequency. Associations between burnout and factors related to physical work environment, workload and schedule, compensation package, interpersonal relationships, intellectual enrichment, and exposure to ethical conflicts were analyzed.

MEASUREMENTS AND MAIN RESULTS

Burnout, characterized by high emotional exhaustion, depersonalization, and low sense of personal accomplishment was common, and was positively associated with perceived medical errors, desire to change career, and depression. Burnout levels on all 3 burnout subscales were higher in this population than previously reported for a contemporaneous group of trauma nurses working with human patients (P < 0.05). Burnout was negatively associated with resilience. Respondents' feelings of fear or anxiety around supervisor communications, perception that patient load was too high to allow for excellent patient care, and perceived lack of available assistance during sudden workload increases were all associated with burnout.

CONCLUSIONS

Burnout in veterinary technicians is common and is associated with numerous undesirable outcomes. Work-related interventions to reduce burnout should focus on improving supervisor relationships and maintaining an appropriate patient:caregiver ratio.

Development of School and Sport Burnout in Adolescent Student-Athletes: A Longitudinal Mixed-Methods Study

We investigated the development of school and sport burnout in adolescent student-athletes (N Time 1 = 391, N Time 2 = 373) during their first year in upper secondary school using an embedded mixed-methods design. The questionnaire-based data were analyzed with growth mixture modeling and four burnout profiles were identified among student-athletes. From the found burnout profiles, two were typical for the interviewed subsample of elite athletes (n = 17), that is, burnout risk and non risk profiles. We generated rich descriptions of well-being and ill-being, showing that elite athletes in two burnout profiles differed in their experienced demands and resources related to individual and environmental factors. The results can be used to generate practical tools for burnout detection in student-athletes' educational path.

Intervention for burnout among postgraduate chemistry education students

Objective

This study investigated the efficacy of a group rational emotive behavioural intervention for burnout among postgraduate chemistry education students in Nigeria.

Method

Participants were 36 postgraduate chemistry education students with high burnout symptoms; 18 students were randomly assigned to an experimental group and 18 to a control group. The Oldenburg Burnout Inventory – Student Version was used to assess burnout.

Results

There was no significant difference between the experimental group and control group in pretest mean burnout scores. However, experimental group posttest scores showed a significant improvement compared with both experimental group pretest scores and with control group posttest scores, indicating that the group rational emotive behavioural intervention was effective in enabling postgraduate chemistry education students to manage burnout. Experimental group follow-up scores showed a significantly sustained improvement compared with both experimental group posttest scores and with control group follow-up scores, indicating that the effect of the intervention was maintained at follow-up.

Conclusion

The group rational emotive behavioural intervention was an effective treatment modality for burnout in postgraduate chemistry education students.

Initial Challenges of Caregiving During COVID-19: Caregiver Burden, Mental Health, and the Parent-Child Relationship

Research confirms that the mental health burdens following community-wide disasters are extensive, with pervasive impacts noted in individuals and families. It is clear that child disaster outcomes are worst among children of highly distressed caregivers, or those caregivers who experience their own negative mental health outcomes from the disaster. The current study used path analysis to examine concurrent patterns of parents' (n = 420) experience from a national sample during the early months of the U.S. COVID-19 pandemic. The results of a multi-group path analysis, organized by parent gender, indicate good fit to the data [X²(10) = 159.04, p < .01]. Results indicate significant linkages between parents' caregiver burden, mental health, and perceptions of children's stress; these in turn are significantly linked to child-parent closeness and conflict, indicating possible spillover effects for depressed parents and compensatory effects for anxious parents. The impact of millions of families sheltering in place during the COVID-19 pandemic for an undefined period of time may lead to unprecedented impacts on individuals' mental health with unknown impacts on child-parent relationships. These impacts may be heightened for families whose caregivers experience increased mental health symptoms, as was the case for fathers in the current sample.

Parkinson's Symptoms and Caregiver Burden and Mental Health: A Cross-Cultural Mediational Model

Informal caregivers are critical in the care of individuals with Parkinson's disease (PD) and spend substantial time providing care, which may be associated with negative caregiver outcomes such as burden and mental health issues. Although research in the United States and Europe has generally supported these relations, there is very limited research on PD caregiving in Latin America. The current study examined the following connections in a sample of PD caregivers from the United States (N = 105) and Mexico (N = 148): (a) PD-related impairments (motor and nonmotor symptoms) and caregiver burden, (b) caregiver burden and caregiver mental health, and (c) PD-related impairments and mental health through caregiver burden. Study results uncovered significant relations among PD-related impairments, caregiver burden, and caregiver mental health. Further, caregiver burden fully mediated the relation between PD-related impairments and caregiver mental health at both study sites. Findings highlight a number of important intervention targets for caregivers and families, including caregiver burden and mental health.

Decreasing radiologist burnout through informatics-based solutions

Increased performance demands have interacted with suboptimal use of technology and contributed to burnout among radiologists. Although the problem of radiologist burnout has been well documented, there is a gap in the literature in terms of how technology can be better utilized to lessen the problem. Informatics-based modifications to existing technology hold the potential to reduce the amount of time radiologists spend on noninterpretive tasks, decrease interruptions, facilitate connections with colleagues, and improve patient care. Examples of successful modifications to technology are presented and discussed in relation to how they contribute to improving workplace engagement among radiologists.

Exploring burnout and depression of Thai medical students: the psychometric properties of the Maslach Burnout Inventory

OBJECTIVES

To examine the psychometric properties of the Maslach Burnout Inventory-Student Survey (MBI-SS) Thai version and to determine the frequency of burnout and correlation between burnout and associated factors.

METHODS

A cross-sectional study was conducted among undergraduate medical students using convenience sampling (n=545, 76.1% response rate, female 52.1%). Data were collected by a self-report survey. The MBI-SS was translated in Thai and tested for internal consistency using Cronbach's coefficient alpha. A confirmatory factor analysis was performed using as fit indices of the chi-square and degree of freedom ratio (χ²/df), Comparative Fit Index (CFI), the Goodness of Fit Index (GFI), the Non-normed Fit Index (NNFI), Akaike information criterion (AIC) and the Root Mean Square Error of Approximation (RMSEA). Spearman and Kendall's tau-b were used to identify correlations between burnout, depression and other factors.

RESULTS

Interrater reliability was acceptable with Kappa of 0.83. Confirmatory factor analysis demonstrated good fit indices (χ²/df=197.62/83, CFI=0.97, GFI=0.95, NNFI=0.96, AIC=271.62 and RMSEA=0.06). Burnout had a weak, positive association with the PHQ-9 (r=0.294, df=2, p< 0.001). The screening depression score had a significant, modest positive association with emotional exhaustion (r=0.469, df=4, p<0.001) and cynicism (r=0.411, df=4, p< 0.001), and a weak inverse association with professional efficacy (r=-0.273, df=4, p< 0.001).

CONCLUSIONS

The Thai version of the MBI-SS had adequate psychometric properties among Thai medical students and can be used to assess burnout among undergraduate medical students in Thailand. Burnout was associated with risk for depression. Further studies on other associated factors contributing to depression are suggested.

Effort-reward imbalance at work is associated with hair cortisol concentrations: Prospective evidence from the Dresden Burnout Study

Chronic stress experienced at work is considered a major health challenge for modern societies. In fact there is ample evidence that deleterious work environments, based on high efforts in relation to few rewards, substantially augment the risk for a number of highly prevalent diseases (e.g. ischemic heart disease, stroke). One potential pathway mediating these associations involves the stress-related activation of the hypothalamus-pituitary-adrenocortical (HPA) axis with proceeding alterations in the secretion of its main effector hormone cortisol. In this study we assessed a prospective, two-year effect of effort-reward imbalance (ERI) on cortisol secretion, based on a sub sample (N = 150; mean ± SD age: 42.4 ± 11.1; 84.0% female) of the ongoing Dresden Burnout Study (DBS). The provided ERI measures were collected as part of the online baseline and first follow up assessment. Further, cortisol secretion patterns over prolonged periods of time were evaluated in three consecutive years of laboratory baseline and follow up visits. Our findings suggest prospective associations between ERI and cortisol, indicating a blunted cortisol secretion in response to long-term work stress (p < 0.001). Given the regulatory properties of cortisol on various central and peripheral target tissues (e.g. cardiovascular system, liver, adipose tissue), a long-term decrease of cortisol availability can be hypothesized to cause multiple health-challenging consequences. Based on our findings, providing work environments where high efforts are always linked with high rewards have to be considered an important issue for employees health.

Sex Differences in the Relationship between Student School Burnout and Problematic Internet Use among Adolescents

Background: The Internet has many positive sides, but it can also have a negative impact on human emotional-cognitive and behavioral functioning, especially during adolescence. To the most common consequences, the authors add addiction of the teenager to the Internet. This addiction is related to many negative physical and mental problems, including depression, substance abuse and social isolation. Methods: In the study, SSBS (Student School Burnout Scale) was used to measure the level of burnout, and the level of Internet addiction was measured using PUI (Internet Addiction Test). The research was carried out among 230 individuals aged 17–20 years. Results: The results of the research showed that higher level of school burnout is related to higher Internet addiction indicators, and connection was stronger in the male group. Gender significantly predicted Internet addiction and moderated the link between school burnout and Internet addiction. Hierarchical multiple regression analyses confirmed different predictors of Internet addiction for male and female students. However, for both groups, higher burnout due to parents was a significant predictor of Internet addiction (IA). Discussion: Internet addiction was predicted by school burnout, appearing as a result of parental pressure for high school achievements. In addition, school burnout and school-related characteristics have greater prediction power of Internet addiction and its indicators in a male group.

Investigation of burnout syndrome among electrical and building technology undergraduate students in Nigeria

BACKGROUND

The investigation of burnout among undergraduate students is yet to receive the same amount of attention as burnout in employees. Despite the negative effects of burnout among students, there is dearth of literature on burnout problem among electrical and building technology undergraduate students. Therefore, this study aimed to determine the burnout levels and the effect of rational-emotive behavior therapy (REBT) on symptoms of burnout among electrical and building technology undergraduate students in South-East zone of Nigeria.

METHOD

A group randomized trial design involving a treatment group versus no-treatment group was adopted for this study. One hundred fifty four undergraduate students of electrical and building technology who met the study's inclusion criteria were selected from public universities in the South-East zone of Nigeria. The intervention consisted of 10 weeks of REBT treatment and 8 weeks of follow-up meetings conducted at 4 months. A self-report questionnaire was used for data collection. Repeated-measures analysis of variance, paired sample t test, and Chi-Squared were used for data analysis.

RESULTS

The outcome indicated that the levels of burnout syndrome among the students are high and REBT had a significant effect on the symptoms of burnout syndrome among the electrical and building technology students in the treatment group compared to their counterparts in the no-treatment group. Finally, the positive gains were significantly maintained by the treatment group at follow-up.

CONCLUSION

The current study suggests that an REBT program can be effective for dealing with burnout syndrome among the population of undergraduate students of electrical and building technology in Nigeria.

Exploring the implications of a self-care assignment to foster undergraduate nursing student mental health: Findings from a survey research study

BACKGROUND

Nursing students experience numerous personal, academic, and practice-related stressors, impacting their mental health. Nursing programs often contribute to student stress and should incorporate strategies to support students' mental health. Self-care has the potential to enhance students' ability to manage current stressors and to build capacity for addressing future stress and burnout; however, the concept has been limitedly integrated into nursing education.

OBJECTIVES

To examine students' responses to a self-care assignment integrated into core nursing coursework.

DESIGN

Cross-sectional study using an online survey.

SETTINGS

An accelerated two-year undergraduate nursing program in Western Canada.

PARTICIPANTS

Undergraduate nursing students in first- and second-year of a two-year program.

METHODS

A 16-question survey, including closed- and open-ended response fields was developed by the research team. Survey questions were grounded in Bloom's Cognitive, Psychomotor, and Affective learning domains to comprehensively examine the impact of the assignment on students' learning and self-care capacity.

RESULTS

89 participants completed the survey (49% response rate). Participants' increase in self-care practices pre- and post-assignment was statistically significant (p = 0.023). Results further demonstrate that students' knowledge of self-care and capacity to identify and manage stressors were enhanced. Participants reported that overall the assignment supported their well-being. However, some participants described that aspects of the assignment detracted from well-being, including challenges with grading and feelings of guilt when not practicing self-care.

CONCLUSIONS

A self-care assignment is an effective strategy for nursing educators to foster students' capacity to cope with stressors.

Stress and Illness: A Role for Specific Emotions

Research on stress and disease has often afforded an important role to emotion, typically conceptualized in broad categories (e.g., negative emotions), viewed as playing a causal role (e.g., anger contributing to pathophysiology of cardiovascular disease), and measured using self-report inventories. In this article, I argue for the value of evaluating specific emotions, considering bidirectional causal influences, and assessing actual emotional responding when considering the role that emotions play in the stress-disease relationship. In terms of specificity, specific emotions (e.g., anger, sadness, and embarrassment) can be linked with particular health outcomes (e.g., cardiovascular disease and musculoskeletal disease). In terms of bidirectionality, the influences of emotions on disease as well as the influences of disease on emotional functioning can be considered. In terms of assessing actual emotional responding, emotions can be studied in vivo under controlled conditions that allow behavioral, physiological, and subjective responses to be measured during different kinds of emotional functioning (e.g., responding to emotional stimuli, interacting with relationship partners, and downregulating emotional responses). With these considerations in mind, I review early theories and empirical studies in psychosomatic medicine that considered the role of specific emotions and emotion-related behaviors. Studies from our laboratory are presented that illustrate a) differences in patterns of autonomic nervous system responding associated with specific emotions, b) relationships between specific emotions and particular health outcomes in the context of social relationships, c) age as a moderator of the relationship between specific emotions and well-being, d) bidirectional influences (emotions influencing disease and disease influencing emotional functioning), and e) impact of changes in emotional functioning in individuals with neurodegenerative diseases on the health of familial caregivers.